Recreation Programming Permission Slip Form

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Recreation Programming | Permission Slip Form
To be completed by Parent/Guardian
Permission has been granted for
to attend the following trip(s) with (name of
program)
1. Trip:
Cost: $__________ (Admission: $___________ + Bus fare: $___________)
Leaving on the __________ day ___________ at __________ am/pm.
Returning on the __________ day ___________ at __________ am/pm.
Additional Information:
2. Trip:
Cost: $____________ (Admission: $____________ + Bus fare: $____________)
Leaving on the __________ day ___________ at __________ am/pm.
Returning on the __________ day ___________ at __________ am/pm.
Additional Information:
Total cost $ __________
Please return money (cash only) and permission slip by:
The following will also be required:
 Lunch
 Change of clothes
 Hat
 Sunscreen
 Swimsuit
 Water/Cool drink
 Towel
 Other:
Signature of Parent/Guardian:
Permission Slip Form
Updated May 2015

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